[Prognosis of skeletal metastases]

Surgical resection of osseous metastases is becoming more and more important in obtaining longer overall survival in carcinoma patients. In 228 cases surgically treated at our institution between 1980 and 1993, the survival was 49% after 1 year, 32% after 2 years, 22% after 3 years and, finally, 11% after 5 years. Retrospectively evaluated, breast and thyroid carcinoma proved to be of positive prognostic influence and lung cancer of negative significance. As a main significant parameter, further extraosseous metastases were evaluated. The prognostic influence of the number of osseous lesions could only be demonstrated in breast and renal cell carcinoma without involvement of further organs. Age and location of the skeletal lesions proved to be of no prognostic influence. Based on these prognostic parameters, three subgroups of patients with worse, median and good long-term survival could be defined. In conclusion, the indication and amount of surgery can be based on these prognostic factors, leading to a decrease in morbidity and hospitalization time in patients with limited survival.